Trombose venosa cerebral e homocistinúria: relato de caso

Homocystinuria presenting as cerebral venous thrombosis is not usual. We report on a 13-year-old boy who was admitted to the hospital due to severe headache, nausea, vomiting and fever (38ºC). The patient was Marfan like and presented left hemiparesis and meningeal irritation sings. He was mentally...

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Detalles Bibliográficos
Autores: Silva, Gisele Sampaio [UNIFESP], Almeida, Carlos Maurício Oliveira De [UNIFESP], Felix, Evandro Penteado Villar [UNIFESP], Fukujima, Marcia Maiumi [UNIFESP], Ferraz, Henrique Ballalai [UNIFESP], Gabbai, Alberto Alain [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2001
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:portugués
OAI Identifier:oai:repositorio.unifesp.br:11600/1244
Acceso en línea:http://dx.doi.org/10.1590/S0004-282X2001000500032
http://repositorio.unifesp.br/handle/11600/1244
Access Level:acceso abierto
Palabra clave:cerebral venous thrombosis
homocystinuria
trombose venosa cerebral
homocistinúria
Descripción
Sumario:Homocystinuria presenting as cerebral venous thrombosis is not usual. We report on a 13-year-old boy who was admitted to the hospital due to severe headache, nausea, vomiting and fever (38ºC). The patient was Marfan like and presented left hemiparesis and meningeal irritation sings. He was mentally retarded, had severe myopia, and had right lens dislocation one month before. Cranial CT scan was suggestive of cerebral venous infarct. MRI and magnetic resonance angiography showed venous infarcts more prominent in the right thalamic projection with hemorrhagic transformation and multiple foci of cortical (occipital and parietal bilaterally) deep parietal and left capsular bleeding, secondary of thrombosis of the transverse and sigmoid venous sinuses. High levels of homocysteine were detected in the blood and urine. Homocystinuria is an autossomal recessive inborn error of methionine metabolism caused by cystathione-ß-synthase defect in most cases. We discuss the clinical and radiological findings in this patient, analyzing the pathophysiology of the thrombotic events related to homocystinuria.